(Bloomberg) -- Lenders to American Physician Partners have given the emergency medical staffing company more time to repay its overdue loans following the collapse of a refinancing deal last month, according to people with knowledge of the matter. 

The extension came after the company, jointly owned by its member physicians, management and Brown Brothers Harriman & Co., shelved a leveraged loan sale. The package was designed to replace financing that matured on Dec. 21.

American Physician sought to raise $520 million to cover its existing debt and fund planned acquisitions, but struggled to attract investors even after it made creditor-friendly changes to the terms and sweetened pricing.

Representatives for American Physician, which is based in Brentwood, Tennessee, didn’t respond to a request for comment, while Brown Brothers Harriman declined to comment. Reorg previously reported on the loan extension.

Default Risk 

American Physician had about $472 million due last month, according to a Dec. 13 note by S&P Global Ratings, which cut its rating on the debt to CCC- because of the high risk of a near-term default. 

The company provides emergency medicine and medicine management services to hospitals and healthcare systems; about 88% of its revenue coming from physician staffing for emergency rooms, according to S&P. Volume has been recovering in recent quarters after demand suffered during the pandemic as patients avoided large hospitals, S&P said.

But the company’s loan offering was clouded by concerns tied to The No Surprises Act, a federal law effective in January that protects consumers from large, unexpected bills when they receive emergency services and out-of-network care. It also creates an arbitration process between insurers and providers to resolve payment disputes. 

The legislation could weigh on the company’s revenue depending on the percentage of its out-of-network patients, billing practices and arbitration process, Moody’s Investors Service wrote in November. 

American Physician generates around $651 million in annual revenue, with Texas, Florida, Tennessee, and Arizona representing more than 60% of its profits, according to Moody’s. The company has about 155 contracts with health systems across 17 U.S. states.

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